PHILLIPS INTEGRATIVE HEALTH (NPI# 1619254752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619254752 |
| Entity Type | Organization |
| Organization Name | PHILLIPS INTEGRATIVE HEALTH |
| Other Organization Name | MOUNT MORIAH MEDICAL CENTER |
| Practice Address |
801 Poquonnock Rd Suite 6 Groton CT 06340-4564 |
| Mailing Address |
11 Wicklow Turn Ledyard CT 06339-1341 |
| Practice Telephone | 8604051500 |
| Practice Fax Number | 8003798041 |
| Mailing Telephone | 8604642871 |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |
| Authorized Official Name | DR. HAROLD EUGENE PHILLIPS JR. (OWNER) |
| Authorized Official Telephone | 8604051500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
036959 | CT | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| MOUNT MORIAH MEDICAL CENTER | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | PHILLIPS INTEGRATIVE HEALTH, LLC | 9-11 Wicklow Turn, Ledyard, CT 06339 |
| Street Address |
801 POQUONNOCK RD SUITE 6 |
| City | GROTON |
| State | CT |
| Zip Code | 06340-4564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942780234 | Comprehensive Occupational Medical Associates of Connecticut P C | Clinic/Center | 32 Chicago Ave, Groton, CT 06340-4952 | 2018-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447578 | Luca Health & Wellness, LLC | Clinic/Center | 2475 Albany Ave Ste 205, West Hartford, CT 06117-2523 | 2020-11-04 |
| 1699307751 | Pride Comprehensive Primary Care LLC | Clinic/Center | 7 Warren Rd, Wolcott, CT 06716-3015 | 2020-02-06 |
| 1316405186 | Ct Optimal Wellness, LLC | Clinic/Center | 115 Technology Dr Unit A103, Trumbull, CT 06611-6338 | 2019-03-11 |
| 1922586809 | Emmaus Health LLC | Clinic/Center | 945 Main St Ste 205, Manchester, CT 06040-6064 | 2018-08-01 |
| 1841781382 | Clifford W. Beers Guidance Clinic Inc | Clinic/Center | 41 Marne St, Hamden, CT 06514 | 2018-05-21 |
| 1598284622 | Np Wellness Care | Clinic/Center | 253 Fairlawn Dr, Torrington, CT 06790-5809 | 2017-09-09 |
| 1245773191 | Anchor Health Initiative Corp. | Clinic/Center | 30 Myano Ln Ste 16, Stamford, CT 06902-4532 | 2016-11-27 |
| 1588114870 | Whole Self Wellness, LLC | Clinic/Center | 144 Banjo Sullivan Rd, Griswold, CT 06351-1201 | 2016-10-11 |
| 1265892541 | Amanda M Swan Aprn LLC | Clinic/Center | 33 Harmund Pl, Wethersfield, CT 06109-1209 | 2016-03-01 |
| 1215321666 | Grand Medical LLC | Clinic/Center | 515 Higgins Rd, Cheshire, CT 06410-3326 | 2015-03-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.